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Dr (b)(6) had a patient that presented to his clinic with acute onset of back pain.An xray taken revealed that the flarehawk cage implanted at l5-s1 had migrated posteriorly and mostly out of the disc space.The devices were removed during revision surgery on (b)(6) 2025.Based on a discussion with dr (b)(6), it is likely that the patient was put into an unusual position during her postop recovery period.The patient was in a rehab facility and was dealing with significant constipation and was her hips were placed in a hyper flexed position and had an acute onset of back pain.A review of the dhr, ncmr and complaint records did not identify all related records.The labeling review of stm-00018(e) was performed as it relates to the reported complaint.It was reported that the flarehawk cage had migrated.A discussion with the physician noted the patient was likely put into an unusual position during her postop recovery period.Per stm-00018(e) precautions adequately instruct the patient.Mental or physical impairment, which compromises or prevents a patient's ability to comply with necessary limitations or precautions, may place that patient at a particular risk during postoperative.Postoperative care is important.The patient should be instructed of the limitations of physical activity such as lifting, twisting, or other excessive motions to reduce risk of excessive load bearing on the implant, and that failure to do so may compromise the implant integrity or delay the healing process.The surgeon should instruct the patient on the time frame required prior to returning to full physical activity.An engineering analysis of the returned device found no defects or mechanical failures and the returned implant was found to be locked.Based on the information provided, the implant may have migrated when the patient was put into an unusual position during the postop recovery period.The implant may also migrate when an undersized shim is used.A device problem was excluded and the issue is likely related to user error based on the reported information however a definitive root cause of the implant migration cannot be established.No device or manufacturing issues were identified during the investigation; we will continue to track and trend for related events.File attachments.
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